Comparison of Administration of Recombinant Human Thyrotropin with Withdrawal of Thyroid Hormone for Radioactive Iodine Scanning in Patients with Thyroid Carcinoma

Ladenson, Paul W.; Braverman, Lewis E.; Mazzaferri, Ernest L.; Brucker‐Davis, Françoise; Cooper, David S.; Garber, Jeffrey R.; Wondisford, Fredric E.; Davies, Terry F.; DeGroot, Leslie J.; Daniels, Gilbert H.; Ross, Douglas S.; Weintraub, Bruce D.; Hay, Ian D.; Levis, Silvina; Reynolds, James C.; Robbins, Jacob; Becker, David V.; Cavalieri, Ralph R.; Maxon, Harry R.; McEllin, Kevin; Moscicki, Richard A.

doi:10.1056/nejm199709253371304

Cited by 413 publications

(226 citation statements)

References 20 publications

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“…No entanto, estudo realizado por Landerson comparando a realização de RCT com TSHrh ou com interrupção do tratamento hormonal demonstrou que esta última alternativa é mais eficaz, talvez pelo aumento da biodisponibilidade do radioiodo no hipotireoidismo, aumentando a capacidade de detecção tumoral (42). O uso de TSHrh pode ser especialmente útil em pacientes com baixo risco de recorrência tumoral, nos quais a indução do hipotireoidismo apresente riscos maiores, como depressão, insuficiência cardíaca grave entre outros.…”

Section: Rastreamento Corporal Total Com Radioiodounclassified

Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento

Golbert

Wajner

Rocha

et al. 2005

Arq Bras Endocrinol Metab

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RESUMOO câncer de tireóide é responsável por cerca de 1% dos novos casos de doença maligna diagnosticados. A maioria destes tumores são carcinomas papilares e foliculares, também denominados de carcinomas diferenciados de tireóide (CDT). Estes carcinomas têm uma taxa de cura de aproximadamente 80%, enquanto 20% apresentarão recorrência local e 5 a 10% desenvolverão metástases à distância. Porém, alguns pacientes apresentam uma doença mais agressiva. A identificação de tais pacientes tem grande impacto no manejo clínico do CDT. Várias classificações de estádio clínico e fatores prognósticos são apresentados, bem como os principais exames para seguimento dos pacientes com CDT. Thyroid carcinoma accounts for roughly 1% of all new malignant diseases. Of these, at least 94% are differentiated thyroid carcinoma (DTC), either papillary thyroid carcinoma or follicular thyroid carcinoma. Patients with DTC are usually considered as having a good prognosis, 80% of patients are cured, 20% will develop loco-regional recurrence and 5-10% distant metastasis. However, the disease may have an aggressive course in some patients. The identification of these patients has a major impact in the clinical management of DTC. Several prognostic factors and classification will be addressed, as well the most useful tests for patient's follow-up. CARCINOMAS DIFERENCIADOS DE TIREÓIDEO CÂNCER DE TIREÓIDE é a neoplasia maligna mais freqüente do sistema endocrinológico, apesar de ser uma patologia relativamente rara, sendo responsável por aproximadamente 1% dos novos casos de doença maligna (1). A cada ano, nos EUA, surgem 14.000 novos casos, e ocorrem 1.100 mortes decorrentes do carcinoma diferenciado da tireóide (2). No Brasil, estes números são proporcionais, ocorrendo 66 novos casos em cada 100.000 habitantes por ano (3).As neoplasias da tireóide são classificadas de acordo com o tipo histológico em adenoma folicular, carcinoma papilar, carcinoma folicular e carcinoma anaplásico ou indiferenciado. A maioria dos tumores tireoi-

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Section: Rastreamento Corporal Total Com Radioiodounclassified

Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento

Golbert

Wajner

Rocha

et al. 2005

Arq Bras Endocrinol Metab

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“…rhTSH could stimulate target tissues (thyroid remnants and/or thyroid cancer) through TSH receptor without hypothyroidism. After development of rhTSH, its clinical safety and efficacy have been verified [52][53][54], giving an opportunity to conclude that rhTSH would contribute to approve quality of patient life in comparison with L-T 4 withdrawal [55].…”

Section: Therapy For Childhood Thyroid Cancermentioning

confidence: 99%

Childhood Thyroid Cancers and Radioactive Iodine Therapy: Necessity of Precautious Radiation Health Risk Management

et al. 2007

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Abstract. One of the lessons from Chernobyl's legacy on health impact beyond 20 years is not only how to detect and treat the patients with radiation-associated thyroid cancers but how to follow up those who received radioactive iodine treatment repetitively after surgery in order to monitor any recurrence/worsening and also how to predict the risk of secondary primary cancers for their lifetime period. To evaluate the possibility of second primary tumors after radioactive iodine treatment, we reviewed the reports on risks from both external and internal radiation exposure, especially at high doses during childhood through an internet service of the National Library of Medicine and the National Institutes of Health, PubMed by the end of June, 2007, together with our own experience of Chernobyl childhood thyroid cancers. Children who were internally exposed after Chernobyl accident have a long-term risk of well differentiated thyroid cancers. Once they have disease, ironically radioactive iodine ablation is one of the useful therapies after surgical treatment. Elevated risks of solid cancers and leukemia have been found in radioiodine-treated patients, however, so far precious few reports from Chernobyl thyroid cancer patient were published. To reduce the adverse effects of radioactive iodine therapy on non-target tissues, recombinant human TSH has been applied and proved effective. Period of latency of second primary cancers may be very long. Therefore patients treated with high activities of radioactive iodine, especially children cases, should be carefully followed up during their whole lifespan.

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“…A DRI é omitida em texto (13), contradizendo publicação anterior, em que dieta pobre em iodo informal é recomendada (89). Esta omissão se opõe, por igual, à conduta do grupo de que aquele autor participa, em que DRI não é prescrita, embora com a cautela de que sejam medidos iodo e creatinina urinários, antes de cada rastreamento (15).…”

Section: Nos Euaunclassified

“…Até o presente momento, tem o autor, desde a publicação do trabalho de Pineda e cols (23), recomendado DW por ele adatada, face à inacessibilidade a equipamentos apropriados aos métodos dispendiosos, sofisticados e cansativos existentes para a medida da iodúria. Esta é utilizada por autores que não recomendam DRI, mas asseguram-se contra a existência de contaminação (15,108) ou prescrevem dieta, mas preferem confirmar sua eficácia (29,(35)(36)(37). Tratando-se de pacientes expostos a contaminação, por procedimentos cirúrgi-cos e radiológicos recentes, é a iodúria considerada de rotina (37).…”

Section: No Brasilunclassified

“…No estado de hipotireoidismo que se observa, à suspensão do tratamento supressivo, a elevação do TSH endógeno estimula a atividade iodocaptante do tumor e de restos de tireóide. Mais recentemente, vem se testando com promissora expectativa (13), o TSH humano recombinante, que evita o prolongado hipotireoidismo necessário para elevar o TSH endógeno (14)(15)(16)(17)(18)(19).…”

Section: Introdução E Históricounclassified

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Dietas com restrição de Iodo (DRI)

Wolff

1998

Arq Bras Endocrinol Metab

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In the context of differentiated thyroid cancer management with radioiodine, a gradual description of low iodine diets (LIDs) is undertaken. A more ample and autoexplicit one is reported, as well as the mechanisms of uptake increase, based on iodine depletion. The efficiency of LIDs in favoring iodine depletion and scanning, as potentially useful for 131 I ablation, but unsettled for 131 I treatment, is examined under the distress of wanting research on the subject. The usefulness of urinary iodine assay to avoid contamination, to appraise adherence to, and efficiency of LIDs, is stressed. In face of increased intake of iodine in the USA, UK and Pacific regions, it is to regret the scarce LID adoption in reports, whose credibility stands only on the belief of tacit informal LID prescription, rarely inserted in "Material and Methods". It is disapproved too the increase in 131 I dose, in case of contamination, since quick depletion of iodine by LID is harmless and efficient. As there is an endemic deficiency of iodine in some regions, it is to doubt the need of LID in Brazil, where no one has been published. Nevertheless, as neither the iodine content of foods, nor the existence of fortuitous excess in some foods are known, the author dares to suggest the

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Comparison of Administration of Recombinant Human Thyrotropin with Withdrawal of Thyroid Hormone for Radioactive Iodine Scanning in Patients with Thyroid Carcinoma

Cited by 413 publications

References 20 publications

Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento

Carcinoma diferenciado de tireóide: avaliação inicial e acompanhamento

Childhood Thyroid Cancers and Radioactive Iodine Therapy: Necessity of Precautious Radiation Health Risk Management

Dietas com restrição de Iodo (DRI)

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